Psychological violence in the marriage presents itself as a multifaceted phenomenon that assumes importance in the field of psychotherapy for treating those involved in this context. The present case study refers to a 32 and 40 years-old heterosexual couple, no child, whose marital care took place for 20 sessions during 10 months of follow-up due to multiple conflicts. For the understanding of the case, we used a measurement scale of violence (CTS2) and reports of the couple psychological care. The CTS2 identified the presence of psychological violence and excluded other expressions of violence. They were identified with experiences of violence in families of origin of partners, communication difficulties and emotional expression, such aspects that extended the relational difficulties. The couple was assisted and helped in the recognition of their own family histories, their emotions and dissatisfaction and, as a result, could progressively recognize themselves as an active participant in conflict resolution, qualifying the relationship to both.

Keywords: conjugality, psychological violence, intimate partner violence (IPV), therapeutic process

Although the theme of marital violence has been studied since the 1970s, from a feminist perspective, psychological violence between spouses remains a phenomenon little explored in contemporary times, being identified primarily as supporting in cases of physical and/or sexual violence. The studies focused on marital violence, commonly refer to physical violence of men against women in a classic gender perspective.^1‒6 Prevalence data reveal the endemic character of the world population, indicating that at least one in three women are victims of some form of violence during their lifetime, and about 35% to 70% of homicides with female victims are committed by their affective partners.^7‒11 However, these studies consider predominantly the gender perspective of men against women. In different contexts, epidemiological studies estimate that between 26% and 34.5% of women experience some form of violence from their affective partners.^8,11,13‒15 By considering man-directed violence as early as the last decade, Hirigoyen¹⁶ reported that 3% to 5% of heterosexual men were victimized by their partners. The same author questions the possibility of underreporting the data, considering the difficulty of men to confess their situation of violence and seek psychological and/or social help. Corroborating the above data, the study by Panuzio and DiLillo,¹⁷ conducted in the USA, revealed that 24% to 44% of women reported having engaged in some kind of violence against their partners in the early period of their conjugal life, besides highlighting the two-way character of violence in many of these relationships.

The breadth of the data presented, however, refers to the noticeable part of the phenomenon, therefore, to physical violence, leaving psychological violence barely visible, given the very character through which it presents itself. The difficulty in recognizing this type of violence can be an obstacle in case identification and reporting.¹⁸ This model of violence is characterized by a highly reciprocal expression that leaves no marks on the body, but hurts the self-esteem, decision-making power and recognition of the aggressed person, constituting a phenomenon as harmful to the human psyche as injuries caused by physical aggression.⁵ It is also associated with higher rates of psychological illness when compared to people not involved in psychologically violent contexts.¹⁹

Regarding the possibilities of intervention in contexts of conjugal violence, studies commonly present the importance of care and protection to the female victim and the punishment of the aggressor.^9,20 Little is referred to the clinic with couples in situations of violence, based on care aimed at understanding and transforming the marital dynamics established by the couple who, in view of the almost impossible conflict resolution, use psychological violence as an alternative to coping.²¹ Consideration should be given to the established relational model, since even in the event of termination of the relationship, there is a possibility of future relationships and is expected to be healthier and more functional.

For the purposes of this study, the systemic family theory subsidizes the understanding of the case, starting from the understanding of conjugal psychological violence as a phenomenon with reciprocity characteristics, in which the co-participation of spouses is identified to some extent^21,22 and transmitted by transgenerational standards.²³ Violent conjugality in these contexts comes from a characteristic relational dynamic, in which the functioning established by the spouses presents itself with a dysfunctional interaction and co-authorship of man and woman in a silent expression of the relationship.²¹

Aim

The aim of this paper is to present and analyze the study of a clinical case of a couple treated in conjugal therapy in situations of psychological violence, in the light of systemic theory. In addition to identifying violence, we sought to explore the aspects that constituted the marital dynamics, favoring relational reorganization, favoring communication, as well as the affective expression and dissatisfaction of partners.

This research was qualitative, with exploratory design, presenting a unique case study. This methodological choice was based on the need to deepen the aspects involved in marital dynamics in the contexts of psychological violence, as well as highlighting aspects of intervention with the couple. Similar research method was adopted by Yin²⁴ who highlights case studies as the preferred strategy when the researcher's questions are of an investigative nature, with little control over the researched events and focusing on contemporary phenomena inserted in some real life context.

Participants

The participants were a heterosexual couple, being the 32-year-old woman and the 40-year-old man who had been living in a stable union for eight years, no children, residents of the state of Rio Grande do Sul, Brazil. The couple was chosen by the criterion of convenience, because they sought marital psychological help in a private clinic of multiprofessional health care.

Instruments

Revised conflict tactics scale (CTS-2): an instrument that proposes to investigate, relationally, the actions of the respondent and his spouse regarding violent behavior, in the dimensions of sexual coercion, physical violence, insult, negotiation and psychological aggression. Presented in a checklist model, the respondent marks the answers according to the frequency of situations pointed to the different possibilities of violence.²⁵ The questions investigated in this scale evaluate the forms of violence in subgroups described as severe or minor. As an example of psychological violence, we highlight issues such as “Did you insult or insult your partner? Did your mate do this to you?”, or “Did you destroy anything that belonged to your mate on purpose? Did your partner do that?” among other questions. The partners responded to CTS2 in the first care, as part of the marital evaluation, and the results contributed to the understanding of the case.

Reports of marital care: reports of systemic marital psychotherapeutic care were used in the course of 20 consultations, lasting one hour each, over approximately 10 months, progressing weekly and then biweekly.

Research procedures

The couple sought psychological care due to important marital conflict. For inclusion in this research, they underwent CTS-2 to evaluate marital violence. The results indicated the presence of psychological violence and exclusion of indicators of physical or sexual violence. The couple was then invited to participate in this study. At the same time, the Terms of Free and Informed Consent (IC) were provided, respecting the ethical rigor concerning research with human beings. After all the clarifications about the study procedures, data use, acceptance and signature of the participants, the consultations began. The sessions were recorded in a digital file for later analysis and the names of the participants were changed to preserve their identities. Data analysis was based on the understanding of the case records, from a systemic perspective of marital dynamics associated with the results obtained on the violence measurement scale (CTS2).

At the beginning of the first service, Nina and Edu responded to the violence measurement scale and revealed that they not only suffered psychological violence but also practiced it. The fact of the result of the practice of violence as well as subjection to it, refer to the dynamism of the phenomenon in question, since the positions of aggressor and victim are altered and are not static, as now who is assaulted can also assault, feeding the dynamics. Existing.²¹

Nina and Edu had lived together in stable union for about eight years and sought marital psychotherapy because they could no longer stand the context of intense conflict they experienced. Although they sought psychological counseling as a couple, Nina repeatedly brought the guilt of her partner. She, frankly depressed, blamed herself for choosing a "difficult" husband who often made her frightened. He acknowledged his “eventual relationship difficulties” by identifying with “harsh behavior” but did not understand the reasons why his wife sometimes felt embarrassed or even afraid, since according to him this was “only the way of being". Edu was a determined, imposing man with rigid positions, which sometimes left Nina with no alternative to bargaining. “I get no action. When he wants something, the world can fall that my opinion is not worth. Damn me and heed it, because otherwise, he explodes! Or he closes, making me feel extremely guilty”. At the beginning of the relationship, Nina was enchanted by Edu's “strong appearance”, who, in turn, became interested in her partner's “delicacy”, conditions that then compromised the relationship, as their roles they seemed rigid. Two weeks after the courtship began, Edu moved to Nina's house, having no time to get to know each other or to decide clearly and directly to share life. Nina says that when she realized "Edu was there, sleeping and waking up with me". This was the decision to live together.

Nina was diagnosed with depression at age 18, after two major episodes. Although she reported no suicidal attempt or ideation, she reported that she had been unable to leave home for the first depressive crisis for a week. She associated the onset of illness with leaving her maternal home when she moved to a large urban center to continue her studies. At the time, she had psychiatric follow-up for about a year and then, at age 22, after another crisis, she sought psychiatric care again, alleviating her symptoms. About six years ago, Nina felt more stable about decreasing depressive symptoms, although she recognized the need to “always be alert”. She said that with each major disagreement with Edu, she used to “fell bad for weeks” and that her husband was not sensitive to it, seeing/judging her as “fragile and weak”, which seemed to feed/increase her self-perception of disability and dependence.

In the psychotherapy course, among other techniques used, the Family Genogram was performed,²⁶ as a strategy for the partners to revisit their families of origin, appropriating their individual histories as well as understanding more broad, the history of the spouse. Nina revealed her own father as an affectionately distant man, little involved in family life, who left her "very attached" to her mother. She recalled, emotionally, the conflicting relationship of parents during their childhood and adolescence. He remembered in detail the episode of physical violence in which the father assaulted the mother. She mentioned her father's fear and anger, taking refuge in a room in the house that could not be seen. Since then, she felt that her mother could not be alone, on pain of being “assaulted by life”, which made her understand the strong affective bond he established with her.

Edu understood marriage as something that needed to be maintained at all costs, even if it was a source of suffering. He remembered his mother as an aggressive, impulsive person with a conduct of verbal violence. “I saw my mom and dad having horrible fights… My mom was crazy, and my dad held on tight! So, I think nothing is so serious”. Edu's father had been a “very submissive man. I can't imagine myself being like this with Nina”. Edu's name is the composition of the names of his father and paternal grandfather, both with troubled marital history, his father for submission to his wife, and his grandfather for his hostile behavior toward Edu's grandmother. Edu's name seems to represent, to some extent, the family legacy of conflicting marital experiences, of the role of power in relation to his wife while fearing to submit to her.

Nina, by contrast, belongs to a family in which “it is rare to be married. Everyone separates easy. Complicated, separated”. The realization of the genogram allowed Nina and Edu to identify the perpetuation of a history of relational failure marked by the relationship of submission / hierarchy, a model brought from their families of origin. She had soft-spoken, always-low tones that gradually and subtly increased with advancing therapy as she was able to position herself more and better in both therapy and marital relationship. In the first calls, she spoke little, in a low voice, looking at Edu, as if asking for his permission to express herself, revealing faces of what she calls “fear”, which is described by Hirigoyen¹⁶ as a form psychological violence defined as intimidation. Nina points out that it is not easy to be perceived by the extended family as a woman who lives “a troubled marriage”, feeling “pressure to separate. It's hard ... Edu makes my relationship with my parents difficult, I don't like to go to my relatives, sometimes it keeps me from going there, and I end up isolating myself. When I go alone, everyone asks… I go much less than I would like and what I think I should”, expressing Edu's control as an expression of violence associated with attempted isolation.¹⁶ In situations of family crisis, such as when Nina's mother had to be hastily hospitalized for health problems, Edu would repeat: “Don't forget this, Nina! Did you see? Who you call 'family' and 'friends' don't care, they don't get involved. It's only up to me, it's me you have to value”, revealing Edu’s attempts to isolate Nina from her family and friends in yet another expression of psychological violence.¹⁶

The couple realizes the high level of conflict that seems to have gradually increased with increasing coexistence. According to Nina, they fight "for everything and for nothing". She also states that, even having difficulties, the two love each other and want to be together, but she finds living together difficult and sometimes heavy, since everything has to always be as Edu wants, and she, in turn, has difficulty positioning and expressing her desires, desires and feelings. “He imposes himself too much, I get no freedom to express! If things are not what he thinks is right, he gets angry, speaks loudly, knocks on the door. And I get scared, feel cornered”, revealing expressions of intimidation as a manifestation of psychological violence.¹⁶ Edu, in his turn, says that he does not understand why his wife is afraid to speak up, since he does not perceive his own behavior as hostile and intimidating.

The psychotherapeutic process could show how much both participated in the establishment and maintenance of violent dynamics. Nina points out: “As long as I'm submissive, I keep letting him give orders! He may even propose, and I may agree, but we need to decide together! I think I have a right to be heard too, after all, we are part of a relationship! Otherwise, the way I have it is to get revenge, seeking autonomy and then, it increases this vicious circle that bothers me the most and disturbs both of us”, pointing out faces of the husband's controlling behavior,¹⁶ as well as the perception of that the husband's attitudes provokes feelings to take revenge that pushes them in a vicious cycle. Nina realizes that her professional condition and her interaction with people affect her husband's safety. “She has to travel for work and I don't know how many people she meets! Who wouldn't want to meet a beautiful, intelligent, serious woman? I know she loves me, but I'm afraid of others”. Nina, in turn, points out that, when Edu is bothered by her behavior, "he looks at me in a way that I can't even explain ... It seems that he will jump on me". Although she reports that there has never been an episode of physical violence, she believes that “don't have to, his angry eyes and absolute silence ends me! With that, I am feel bad for many days. I think it's kind of strong, but Edu does 'almost violence'”, revealing the difficulty of recognizing psychological violence as such.²⁷ Thus, Nina lives in a climate of permanent threat that is as harmful to the psyche as the situation of violence itself.¹⁶

Nina points out that work itself is the only way to feel valued and the more things don't go well at home, the more she uses it as an escape route. “In these situations, what I need most is to work, to put my head busy somewhere else. Then I go on trips that I really don't like. I volunteer to make the travels of my colleagues, because then, I get out of the loop, decide and realize myself without Edu to control my life”.

Over the course of the visits, the couple could identify in a vicious circle, fed by both. The more Nina tries to escape Edu's power, the more she seeks to exercise control. She, suffocated, invests more in professional activities, contributing to her husband's insecurity. With this, they feed the reality that makes them sick. Although Nina turns to work more intensely, in an attempt to escape her husband's controlling behavior, she ends up to some extent by denying her affective demands, reinforcing Edu's insecurity and contributing to the maintenance of the dynamic of psychological violence.

Progressively, the therapy process helped Nina was able to express herself more in attendances revealing her ideas and feelings. Gradually, she was able to reveal the fear she sometimes felt about her husband, choosing to shut up and accept his impositions at the risk of confrontation. Edu, surprised, could not understand Nina's fear, since “I just wanted to protect her, decide what is best! I am more experienced, I know more about the dangers of life”, which corroborates the mentioned controlling behavior.¹⁶ Edu, hearing Nina talk about violence was impacted by the “force” of his own behavior, seeming emotionally mobilized at the same time as remote memories and experiences of suffering brought from his family of origin were triggered. With this, he could also express not only his dissatisfactions and frustrations, but his low self-esteem. Although Edu highlights, with apparent suffering, the memories of the conflicts experienced in his family of origin, this seems to be the relational model learned and to which he has become accustomed to relate to people, in a tendency to repeat the lived patterns.^28‒31 Nina and Edu's recognition of the relationship of violence that they establish and submit to both becomes a significant factor to the possibility of change.

The perception of both in relation to the spouse was enhanced by the performance of marital care, with special emphasis on the use of the genogram, a technique that allowed them to understand the family logic that involved them. Edu could express his fear of Nina's independence and competence, not just at work, but in life. “She was very protected, sees nothing bad, and I do it for love, because I'm afraid of losing her”, referring again to control as a relational component,¹⁶ which seems to be confused by the couple with care and affection. Even though she likes to enjoying her husband's protection, feels the need to "breathe." She acknowledges that she has been overprotected and that this sometimes gives her a feeling of unpreparedness for life, but feels that “one way or another” needs to be able to take care of herself, as Edu needs to allow, stating that the husband "needs to retreat and, on the contrary, I have to move forward". Nina recognizes her own difficulty in becoming more deeply involved with her husband. “If Edu needs to be taken care of, I also need to learn how to do that, because I don't do that much. I've always been pampered and doing it to others is sometimes not easy. I think I'm afraid of taking more care of him and giving him more strength to control of me and run over me, invading my space...”, referring to some confusion in the perception of the difference between care and submission. Although suffering, both Edu and Nina, eventually naturalized the conjugal violence experienced from the testimony of family violence of origin, a phenomenon previously presented in the literature.²³

Nina's difficulty in expressing herself and expecting to be cared for and protected in a similar way as in childhood reinforces the marital dynamics marked by Edu's intimidation and control in the relationship. Nina, in her own way, was able to express her displeasure when she was “forced” to devote more to work than necessary, triggering in her partner’s the feeling of abandonment and divestment, contributing in some way to the outbreak of violence, psychological. Thus, even though Nina experiences the suffering resulting from psychological violence, it is an integral part of the established relationship, participating in the maintenance of violent marital dynamics.²¹

By proposing the resolution of everyday dilemmas, using the staging technique, the couple was able to reveal Edu's financial control, as for both of them, matters related to the couple's finances were her husband's sole business, leaving Nina on the sidelines of any decision, revealing, once again, control as an expression of psychologically violent behavior.¹⁶ Nina highlighted the difficulty of expressing interest that demands financial investment, pointing out that “if it's my interest, only if it's free. If not, it's under protest, but to buy a tennis shoes very expensive, doesn’t matter, it’s ok! Because Edu understands finance and I understand people”, ironically revealing the rigidity of established roles and the financial issue as a predictor of conflict.^32,33

In this way, Edu and Nina manifest significant difficulty in negotiating conflicts as to putting themselves in the other's place and considering the interest and what is important to the spouse. In this sense, Alvim and Souza³⁴ point to alterity as a significant aspect in the establishment of conjugal violence, since un-negotiated differences are expressed when one spouse denies the existence of the partner in his or her individuality, trying to standardize him and imposing his own way as the only viable possibility to exist.

One of the techniques performed in therapy was the dilemma resolution interview, when the couple needs to find a solution to a disagreement. Seeking an alternative to a situation in daily life, Nina explained that if it mattered to her husband, even if she would be disgruntled, she could give in. “Although I didn’t like it very much, I think I could handle it." Edu, after taking a deep breath, said he believed he would “fight before, during and after”, failing to allow any negotiation with his wife.

Marital therapy also revealed significant difficulty in the couple's sexuality. Initially, Edu was slightly embarrassed to talk about his wife's topic. However, he soon recognized that sexual desire is a difficulty for both of them. “Sometimes if something is bad, what is happen is we don't want to stay together and have sex. The desire sex goes away. Our sexual life is going rare”, revealing how much marital violence relates, to some extent, to lower levels of sexual and marital satisfaction, more broadly, as dissatisfaction is not manifest. And the avoidance of communication and conflict itself are dysfunctional over time.³⁵

Edu's control and intimidation of Nina leaves her without expression, hiding her frustrations in silence. In this sense, Walsh³⁶ highlights the communicational aspect as “the best indicator of marital success” (p. 119), referring to the quality of the relationship based not on the absence of conflict, but on the possibilities of administration by the couple. The same author also points out that the avoidance of conflict is not revealed as a functional aspect, significantly increasing the risk of subsequent marital dissatisfaction. In this sense, Nina and Edu express the adoption of submission as a conflict resolution style, being related to the obedience behavior of the submitted spouse.³⁵ In a similar sense, the couple reveals difficulty in communicational expression, in which verbalizations are omitted, expressing important difficulty in marital verbalization,³⁷ which is confirmed by Nina's speech, when she points out that “problems exist, but they are under the carpet. We have no secrets between us.. What we have is trouble, the size of a train. Everything I feel and what makes me suffer I think he knows. And that is very disturbing, because I ‘think’ he knows and Edu must think that about me too, I imagine... And this is the way we understand each other. Or, actually, we don’t understand...”. In this sense, the patterns of communication established in conjugality are associated with greater or lesser functionality of the conjugal dynamics presented.³⁷

The psychotherapeutic process facilitated the emotional expression of the spouses, emphasizing the possibility of manifesting their pains and weaknesses. Although they had the conflict as something natural in their previous history, they felt that at the slightest sign of disagreement, they needed to retreat, silencing what bothered those most and causing suffering, thus minimizing the “size of the noise”. However, the conjugal psychotherapeutic experience brought to light the need to give voice to the emotions experienced in intimacy under penalty of maximizing the suffering of the partners. Regardless of Edu and Nina's individual difficulties, the couple could understand that directed, assertive, and emotionally charged communication is the best strategy for dealing with the frustrations experienced in conjugality.³⁸ Gradually, the partners were able to express some personal desires and projects that had hitherto been silenced as a way of maintaining protection from each other. From this perspective, the different expressions of psychological violence subvert the expression of verbal communication. Watzlawick, Beavin & Jackson,³⁹ referring to the axioms of communication, points out the impossibility of “non-communication”. Silence and isolation thus present themselves as a form of expression. In this sense, the dissatisfactions experienced in conjugality, even if silenced, manifest themselves in some way, through expressed or veiled behaviors, but always seeking to express some emotional charge.

The welcoming and empathetic presence of the therapist increase the expression of difficult issues to deal in the couple's daily life. If it is difficult to dialogue about conflicting issues in other contexts, the systemic therapist uses specific techniques that seek to foster communication between partners in the context of therapy to facilitate emotional expression and help partners objectively understand what is communicated, without double messages.

 Marital therapy facilitated the communication between the partners, emotional expression, and the sharing of experiences and plans that are commonly decided. Although the violence experiences in their families of origin has left a relevant legacy in the model of relating to conjugality, the psychotherapeutic process was important because it developed with the couple a new relationship model, based on empathy, proper communication and mutual respect.

Final considerations

Marital violence, being a multifaceted phenomenon of multifactorial etiology, requires broad observation of the professional involved in intervention practices with the people involved in this context. It is essential that the therapist can contemplate the different aspects that this situation involves. When considering the systemic perspective, men and women are understood as co-authors of the marital relationship. Therefore the psychologically violent dynamics that are established is a phenomenon that arises from the participation of the partners, to some extent, being both the spouses involved in both building and maintaining the phenomenon of violence. As such, they are also important characters in resolving violent conflict and in establishing a healthier and more functional relational model. Because it, is so important to care about the relationship, and talk each other about their difficulties face to face, with help of therapist, in a controlled environment, to solve the problems.

The couple participant of this study revealed convergent aspects regarding both the difficulty of emotional expression and the family history of violence. Although the expressions of parental conjugal violence took different forms of expression, the experience of violence was naturalized for Edu and Nina, revealing a familiar reality as much suffering as reference. From this perspective, marital choices are shown to this service, to help them to perpetuate of transgenerational patterns of conjugal violence.

The couple participating in this investigation revealed a marital dynamics marked by dysfunctionalities, such as the important communication difficulty, the emotional dullness of spouses with difficulty in emotional expression, fragile conjugality and rigidity in the performance of marital and / or family roles, demonstrating the need to understand them beyond the symptom of violence. In this sense, psychological violence presents itself as the tip of the iceberg of a broader and deeper context that deserves to be observed, understood and dealt with. Thus, it should be noted that more than treating violence as a focus in itself, it has to be understood as a symptom of a relationship that gets sick.

The significant difficulty of emotional expression configures a marital space that is not welcoming and deteriorates intimacy and communication. Silenced dissatisfactions seemed to settle down as a rule, only broken with veiled gestures, words, or expressions that left no mark on the body but wore psychological distress to the point of hurting self-esteem and the ability to recognize one's own potential.

Given this, if the conjugal psychologist considers the couple as a unit that builds the symptom of violence together, and perpetuates it, it also considers it as a potential for transformation of the dynamics that is established. If the partners contribute in some way to the establishment of conjugal violence, the possibility of transforming this reality involves the twosome, maximizing the existing possibilities regarding conjugality and new relational, more functional, healthy and balanced possibilities.

Based on the above, the importance of both understanding and interventions in conjugality is emphasized in order to treat psychologically violent marital dynamics. Considering that from dysfunctional marital contexts symptoms of violence may emerge, it is up to the psychologist / psychotherapist to associate their own clinical and researcher characteristics and to problematize the clinic with couples when searching for data that may point to the possible outbreak of violent expressions. Given this, it is possible to transform unhealthy aspects of the marital relationship and reorganize the current marital dynamics in order to prevent and treat contexts of violence. Thus, more than aggressors and victims, spouses are responsible to some extent for maintaining the generative aspect of suffering. If both are considered co-authors of the dynamics now existing, they may equally be responsible for the change as difficult as necessary to be imprinted on new relational possibilities. Further studies of the therapeutic process with couples involved in psychologically violent contexts are suggested, with subsequent follow up to monitor the maintenance of changes observed in the psychotherapeutic course. In this sense, it is expected to contribute effectively to raise questions and inquiries about marital relationships in the context of psychological violence as well as possible interventions in different marital contexts, both in the form of prevention and treatment.

The case presented highlights the importance of addressing marital dynamics in cases of psychological violence, instead of protecting one and punishing the other, as both participate in some form of violent context. It is necessary to reorganize the dysfunctional aspects, with emphasis on communication, marital roles and emotional expression, aspects that promote psychological violence in the couple. Edu and Nina, in the context of couple therapy, were able to understand their participation in the relationship complaint, and from then on they got involved in a solution and improved their quality of life.⁴⁰

None.

None.

The authors have no conflicts of interest to declare.

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